Jaundice: Causes, Symptoms, Tests and Treatment

Have you noticed yellowing of the whites of your eyes, yellow skin, unusually dark urine or pale-coloured stools? These symptoms may indicate jaundice and should not be ignored.

Jaundice occurs when bilirubin, a yellow pigment produced during the normal breakdown of red blood cells, accumulates in the blood and tissues. It is a sign of an underlying problem rather than a disease in itself.

In adults, jaundice may be associated with hepatitis, liver injury, certain medicines, increased breakdown of red blood cells or blockage of bile flow. Identifying the cause is essential because treatment differs considerably between these conditions.

Important: If you develop new jaundice, seek prompt medical assessment. If it occurs with fever, severe abdominal pain, confusion or unusual drowsiness, go to an emergency department immediately.

What Is Jaundice?

Jaundice is the yellow discolouration of the skin, the whites of the eyes and sometimes the lining of the mouth caused by an increased level of bilirubin.

Bilirubin forms when the body breaks down old red blood cells. The liver processes bilirubin and helps remove it through bile into the digestive tract.

Jaundice can develop when:

• Too much bilirubin is produced.
• The liver cannot process bilirubin normally.
• Bilirubin cannot drain properly through the bile ducts.

The underlying cause determines which tests and treatment are needed.

What Are the Symptoms of Jaundice?

Common signs and associated symptoms include:

• Yellowing of the whites of the eyes or skin.
• Dark urine.
• Pale or clay-coloured stools.
• Itching.
• Fatigue or weakness.
• Reduced appetite.
• Nausea or vomiting.
• Abdominal discomfort.

Some people develop jaundice without significant pain. Others may experience fever, abdominal pain or other symptoms that provide clues to the underlying condition.

Seek emergency care if jaundice occurs with severe abdominal pain, fever and chills, confusion, unusual drowsiness or significant deterioration. These combinations may indicate a serious liver or bile duct problem.

What Causes Jaundice in Adults?

The causes generally fall into three broad groups.

1. Increased Breakdown of Red Blood Cells

Bilirubin production may increase when red blood cells break down more rapidly than normal. This is known as haemolysis.

Possible causes include certain blood disorders, immune-mediated conditions and some infections or medicines.

In these situations, the liver may be processing an increased bilirubin load rather than being the primary site of disease.

2. Liver-Related Causes

Jaundice can occur when liver cells are inflamed or injured and cannot process or excrete bilirubin normally.

Potential causes include:

• Acute viral hepatitis.
• Chronic hepatitis B or C.
• Alcohol-related liver disease.
• Advanced fatty liver disease or cirrhosis.
• Autoimmune liver disease.
• Drug-induced liver injury.
• Certain inherited conditions.

The pattern of blood-test abnormalities, medical history and other findings help distinguish these possibilities.

3. Blockage of Bile Flow

Bilirubin can accumulate when bile cannot drain normally from the liver.

Possible causes include:

• Gallstones blocking the common bile duct.
• Narrowing or scarring of bile ducts.
• Inflammation affecting the biliary system.
• Certain pancreatic or bile duct tumours.

Dark urine, pale stools and itching may occur with impaired bile flow. However, symptoms alone cannot establish whether a blockage is present.

Depending on the clinical findings, imaging and occasionally procedures such as endoscopic retrograde cholangiopancreatography (ERCP) may be needed.

How Is Jaundice Diagnosed?

Diagnosis starts with a medical history and physical examination. Your doctor may ask when the yellowing began, whether it developed suddenly, what medicines or supplements you take, and whether you have abdominal pain, fever, itching or changes in urine and stool colour.

Blood Tests

Depending on the clinical situation, investigations may include:

• Total and direct bilirubin.
• Alanine aminotransferase (ALT).
• Aspartate aminotransferase (AST).
• Alkaline phosphatase (ALP).
• Gamma-glutamyl transferase (GGT).
• Complete blood count.
• Albumin.
• Prothrombin time and international normalised ratio (PT/INR).

Additional tests may be required to investigate viral hepatitis, haemolysis, autoimmune disease or other suspected causes.

These tests provide different types of information. For example, ALT and AST can indicate liver-cell injury, while ALP and GGT may help identify a pattern associated with impaired bile flow. Bilirubin measures help establish the type and degree of bilirubin elevation.

No single blood test can identify every cause of jaundice.

Ultrasound and Other Imaging

An abdominal ultrasound is commonly used to examine the liver, gallbladder and bile ducts when obstruction is suspected.

Depending on the results, your doctor may recommend CT, MRI or magnetic resonance cholangiopancreatography (MRCP).

If a bile duct stone or obstruction requires treatment, ERCP may be appropriate in selected cases.

Is a Liver Biopsy Always Needed?

No. Many cases can be investigated using blood tests, clinical assessment and imaging.

A liver biopsy is considered only when additional information is needed and the expected benefit justifies the procedure.

How Is Jaundice Treated?

There is no single medicine or home remedy that treats every type of jaundice. Management depends on the underlying cause.

Jaundice Due to Viral Hepatitis

Treatment depends on the virus and the severity of illness. Hepatitis A and E often receive supportive management, while hepatitis B and C require assessment according to their specific treatment guidelines and clinical circumstances.

Some patients need monitoring, antiviral treatment or hospital care.

Jaundice Due to Bile Duct Obstruction

If a gallstone blocks the bile duct, an intervention may be needed to remove the obstruction.

ERCP can be used in appropriate cases to remove bile duct stones or place a stent. Treatment of the underlying gallbladder condition may also be required.

Other causes of obstruction need treatment tailored to the diagnosis.

Jaundice Due to Medication-Related Liver Injury

A doctor will review prescribed medicines, over-the-counter products and herbal supplements to identify possible causes.

Do not stop essential prescribed treatment or start a liver supplement without medical advice. Some herbal products can themselves cause liver injury.

Jaundice Associated With Chronic Liver Disease

Management focuses on the underlying liver disease, its complications and ongoing monitoring. Patients with advanced liver disease may require specialist care.

Can Jaundice Be Treated at Home?

New jaundice in an adult should not be managed with home remedies alone.

Avoid relying on sugarcane juice, herbal preparations, detox products or unverified liver tonics to treat the underlying cause. They cannot replace diagnostic assessment, and some supplements may worsen liver injury.

While awaiting medical assessment, follow your clinician’s instructions, avoid alcohol and do not take unnecessary medicines or supplements.

When Should You Consult a Gastroenterologist?

Arrange prompt medical evaluation if you notice:

• Yellowing of the eyes or skin.
• Dark urine with pale stools.
• Persistent itching accompanied by jaundice.
• Unexplained abnormal bilirubin results.
• Jaundice with reduced appetite, fatigue or abdominal discomfort.

Go to an emergency department immediately if jaundice is accompanied by severe abdominal pain, fever and chills, confusion, unusual drowsiness or other signs of serious illness.

Frequently Asked Questions About Jaundice

1. Is jaundice a disease or a symptom?

Jaundice is a sign of increased bilirubin in the blood. It can result from problems involving red blood cells, the liver or the bile ducts.

2. Does jaundice always mean liver damage?

No. Increased red blood cell breakdown and certain inherited conditions can also raise bilirubin. Testing is needed to establish the cause.

3. Are yellow eyes and dark urine signs of jaundice?

They can be. Yellowing of the whites of the eyes and dark urine may indicate elevated bilirubin. New symptoms should be medically assessed.

4. Which tests are needed for jaundice?

Depending on the suspected cause, tests may include bilirubin, liver enzymes, blood counts, clotting tests and abdominal imaging. Additional investigations are selected according to the initial findings.

5. Can gallstones cause jaundice?

Yes. A gallstone that blocks the common bile duct can obstruct bile drainage and raise bilirubin. This may require urgent assessment and, in selected cases, endoscopic treatment.

6. Is jaundice contagious?

Jaundice itself is not contagious. However, some underlying causes, including certain viral hepatitis infections, can spread between people. The risk and prevention measures depend on the specific infection.

7. How long does jaundice take to resolve?

There is no single recovery time. It depends on the cause, severity and response to treatment. Persistent or worsening jaundice needs reassessment.

8. Can jaundice be treated with herbal medicines?

There is no reliable herbal remedy that treats every cause of jaundice. Some herbal and dietary supplements can injure the liver, so discuss any product with your treating clinician.

9. When is ERCP needed for jaundice?

ERCP may be used when a bile duct obstruction, such as a common bile duct stone, requires endoscopic treatment. It is not necessary for every patient with jaundice.

10. Which doctor should I consult for jaundice in Faridabad?

A gastroenterologist or liver specialist can assess jaundice, organise appropriate investigations and coordinate treatment according to the cause. Severe symptoms require emergency assessment rather than waiting for a routine appointment.

Final Advice

Jaundice is a warning sign that deserves proper evaluation. Early identification of the cause helps guide the right treatment and can prevent delays in managing serious liver or bile duct conditions.

If you notice yellowing of your eyes or skin, seek prompt medical assessment rather than relying on home remedies or waiting for the symptoms to disappear.

About the author

Dr Vishal Khurana is a gastroenterologist and liver specialist in Faridabad, Haryana.

Medical disclaimer: This article is for general educational purposes and does not replace an individual medical consultation.